HIMSS14: Health IT's Next Boom Cycle

We've seen health informatics booms and busts before -- will this one be different?

8 Healthcare Startups Catch Fire

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I've been attending HIMSS for decades, and in my view, the exhibit hall is the place to get a true pulse of the industry and the field in general. Over the years we've seen booms and busts. I remember HIMSS in my hometown of Atlanta during the heyday of health information exchange in the 90s, when the regional phone companies (remember them?) had huge exhibits touting their entry into the health informatics space.

I recall in particular running into a former employee of mine. He was then a key salesperson for a major corporation in the financial sector that was entering a plan to dominate healthcare (I will not name names, to protect the innocent). He offered to buy me a cup of coffee, and I readily agreed since I always liked him. Turned out he wanted me to explain to him why they were in the healthcare space and how they might succeed in it. Clearly a boom followed by a bust.

In 2014, we're again in a boom cycle. Is it different this time? Will healthcare welcome new entrants and new IT-enabled capabilities? Will they transform the industry?

To answer these questions, let's first look at who these new players are. The biggest, glitziest booths are mostly from the analytics companies -- several of which are the biggest health insurers in disguise -- and a couple of them are visually stunning: Times Square at HIMSS! The overriding themes this year are quite clear: interoperability, analytics, population health, and patient engagement.

Wow! Are we actually going to focus on how informatics can fix healthcare? Are the whiz-bang features of one EHR versus another finally less important than whether they can talk to each other? Are we actually going to manage chronic disease patients across providers on a continuous basis and admit that what they do is as important as -- if not more important than -- what providers do?

When you talk to the interoperability vendors, most (but not all) understand what an API-based approach to exchange is, and some can even show it. When you talk to the population health management vendors, some have this already built in, and most now offer some form of patient engagement as an integral part of their software suite. I visited one that even offers a sophisticated approach to managing care coordination processes -- all built right in. Conversely, I saw at least one well known EHR system that offers integrated care coordination services.

Moreover, most of these products have simple, attractive, and -- dare I say it -- intuitive user interfaces. I saw one that was done entirely in HTML5. Health IT, even from the major companies, is actually moving into the 21st century.

Finally, the Interoperability Showcase (which last year was somewhat shabby and tucked away from the big boys in the exhibit hall) now shines. It is immediately adjacent to, and seamlessly integrated with, the main exhibit hall -- which itself is the size of several football fields (just ask my feet!). There, the Harvard SHARP team is showing off the latest version of their SMART tools, which are now built using FHIR.

Have we crossed the Rubicon? Sure looks like it. ONC should be proud of what they've accomplished. The final score is far from in, but the game is underway.

A final sad note: the Startup Showcase. HIMSS should be embarrassed. Couldn't they afford to give these promising young companies enough space to adequately show off what they're doing and allow more than a handful of people to see it? Shame.

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Mark Braunstein is a professor in the College of Computing at Georgia Institute of Technology, where he teaches a graduate seminar and the first MOOC devoted to health informatics. He is the author of Contemporary Health Informatics (AHIMA Press, 2014) as well as Health ... View Full Bio

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Sometimes it's best to stand back and reflect/learn more before you speak or write. The last part of my HIMSS posting is an example of that. Thankfully, Richard Scarfo, VP of Events and Director of the HIMSS mHealth Summit, read my post and contacted me after the conference. The Startup Showcase I criticized was the idea of his team at HIMSS. In the past HIMSS regularly featured startups at the mHealth Summit. Richard now runs the Venture+ forum at HIMSS on Sunday which has taken place for the past 7 years. The growth of the Venture+ Forum (spurred by the obvious growth in HIT entrepreneurial activity in the past few years) led to the idea of showcasing startups on the floor of the big HIMSS meeting this year for the first time. Given the demand (1,300 companies exhibited) an ideal space just wasn't available so HIMSS did the best it could. Despite that, the startups report good success and HIMSS plans something larger and more prominent next year.

I appreciate Richard reaching out and educating me and I promise to think twice next time!

In one sense it's a bit early to be sure but two of the strong HIT themes I notds for HIMSS'14 were population health and patient engagement. I found vendors of systems from traditional EHRs to new analytics platforms all touting their capabilities in these areas. I believe this is closely related to the prospect of these new financial incentives.

Mark, What are specific healthcare systems that you are referring wrt "financial incentives to outcomes and efficiency" that are a major underpining of the ACA. Is it just ICD-10 or are there others that are equally significant.

Thanks. I think you need to mentally divide ACA into the patient enrollment part which has gotten so much public attention (and now does seem to be "working") and the part that attempts to change the financial incentives to outcomes and efficiency (Acountable Care). It's really that latter part that is driving the transformation of health IT. The private insurers are moving in the same direction. Whatever the media are focusing on, the industry seems to be paying close attention to the IT support it will need to respond to these new incentives.

Thanks for responding Mark. I definitely won't hold you to a date certain. Crystal balls are notoriously inaccurate when it comes to the pace of IT change, healthIT notwithstanding & despite its promise. But what happened with the ACA last fall put public confidence to an all time low. So it's nice to read about positive developments -- and I'm optimistic that the reality will meets expectation this time....(whenever that is, exactly!)

I believe that like every other sector, healthcare industry must also go the technological way by implementing the advanced EHR medical software system to simplify many of the time-consuming & painstaking operational tasks of a medical office.

Please don't interpret my post as predicting the pace of actual change. Healthcare has always surprised us by moving more slowly than it should. My sense is that the pace has picked up but my crystal ball gets very cloudy if you start asking questions that begin with "When"!

I've been to a few HIMSS conferences myself, and the energy is electric. It feels a bit like Comdex of yesteryear (try to find a hotel nearby and prepare for the long taxi queues), only on a smaller scal...but with meatier content. CIOs and other IT leaders attend this event. It's not just a bunch of people looking for T-shirts and pens. But it also feels a bit like a bubble. Probably half these vendors won't be around in five years, or they won't be in the healthcare IT business. But most of them are chasing genuine market opportunities. This is no dotcom bubble.

That's great news, especially in the wake of the Obamacare debacle this fall. If interoperability, analytics, population health, and patient engagement tech are making the strides you say they are, I look forward to seeing the result in action in our daily lives. Great artice. Thx.

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